Epidemiology of Kawasaki disease in the population of the Caribbean Island of Martinique, 2013–2019

PURPOSE: Kawasaki disease (KD) is a vasculitis of the large and medium vessels. Its description and epidemiology in the Afro-descendant (AD) population and in Latin America and the Caribbean (LAC) are limited. The current study aims to describe the epidemiology and clinical and biological characteristics of children with KD in Martinique. METHODS: Our study was descriptive, retrospective, multicenter epidemiological study including all children aged 0-18 years hospitalized for KD in the pediatric and intensive care units of Martinique from January 2013 to December 2019. KD was diagnosed according to the European SHARE guidelines. RESULTS: Between 2013 and 2019, 63 children were hospitalized with KD in Martinique. The estimated incidence was 34 per 100.000 children under 5 years old (CI95% 27.9-52.5). The male to female ratio was 1.2. Among all patients, 12/63 (19%) had coronary involvement, and 5/63 (8%) had medium or giant coronary aneurysms. No child died of KD during the study. Eighteen children (29%) required a second line of treatment after polyvalent immunoglobulins. The Kobayashi score in our cohort had a sensitivity of 41% (CI95% 28.9% - 53.2%) and a specificity of 78% (CI95% 67.7% - 88.2%) . CONCLUSIONS: Our study is the first epidemiological and descriptive study of KD in a Caribbean island and the first to show the incidence of KD in children in a Caribbean AD population. The incidence was higher than in Caucasian populations, with peaks after arboviral epidemics, but the risk of cardiac complications was similar. The accuracy of the Kobayashi and Kawanet Echo scores were different in our population. Further studies are needed to confirm these trends in AD and LAC populations.